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. 2021 Oct:231:108845.
doi: 10.1016/j.clim.2021.108845. Epub 2021 Aug 31.

Impact of the COVID-19 pandemic in patients with systemic lupus erythematosus throughout one year

Giuseppe A Ramirez  1 , Lorenza M Argolini  2 , Chiara Bellocchi  3 , Luca Moroni  4 , Emanuel Della-Torre  4 , Nicola Farina  4 , Roberto F Caporali  5 , Lorenzo Beretta  3 , Maria Gerosa  5 , Enrica P Bozzolo  6 , Lorenzo Dagna  4 ; SMILE, Milan Lupus Consortium
Affiliations

Impact of the COVID-19 pandemic in patients with systemic lupus erythematosus throughout one year

Giuseppe A Ramirez et al. Clin Immunol. 2021 Oct.

Abstract

Little is known about the impact of coronavirus disease 2019 (COVID-19) pandemic to the care of patients with systemic lupus erythematosus (SLE) in the long-term. By crossing population data with the results of a web-based survey focused on the timeframes January-April and May-December 2020, we found that among 334/518 responders, 28 had COVID-19 in 2020. Seventeen cases occurred in May-December, in parallel with trends in the general population and loosening of containment policy strength. Age > 40 years (p = 0.026), prednisone escalation (p = 0.008) and infected relatives (p < 0.001) were most significantly associated with COVID-19. Weaker associations were found with asthma, lymphadenopathy and azathioprine or cyclosporine treatment. Only 31% of patients with infected relatives developed COVID-19. Healthcare service disruptions were not associated with rising hospitalisations. Vaccination prospects were generally welcomed. Our data suggest that COVID-19 has a moderate impact on patients with SLE, which might be significantly modulated by public health policies, including vaccination.

Keywords: COVID-19; Containment; Coronavirus; Lockdown; Prednisone; Public health; Systemic lupus erythematosus; Treatment; Vaccination.

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Figures

Fig. 1
Fig. 1
Population context. In this figure, the number of cases of confirmed (cCOVID, dark blue) and presumed (pCOVID, pale blue) COVID-19 are depicted in their temporal relation with general population variables, including a) trends of COVID-19 cases in Italy (light blue line); b) trends of security checks to people (dark green line) and businesses (light green line) upon the application of the laws prescribing limitations to gatherings and movements; and c) type and validity of such limitations (table). For each task subject to regulation, a colour-code is applied to distinguish among high- (red), intermediate- (orange) or low-risk (yellow) areas in Italy (the whole Country was homogeneously considered high-risk for almost all the first observation period). Higher-risk colours overlap lower-risk colours where the strictness of a given rule is the same into different risk areas. In addition, rule strictness is graded from 0 (complete freedom) to 2 (complete ban) to generate sparkline graphs for each task. Containment policies were significantly looser in the second observation period. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
Fig. 2
Fig. 2
Symptoms among patients with SLE and their relatives during the second period. Radar graphs showing the prevalence of COVID-19 related symptoms in patients with SLE (blue) with (totCOVID, orange) or without (noCOVID, dark blue) COVID-19 and their family members/cohabitants. The percentage of symptoms was significantly higher in patients with totCOVID than in patients with noCOVID and in patients with SLE compared to their family members/cohabitants. Dry cough, dyspnoea, sore throat, and anosmia or ageusia were significantly more specifically represented in patients with totCOVID, while myalgia and fever were frequent also in patients with noCOVID. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
Fig. 3
Fig. 3
Reasons for vaccine hesitancy and source of information on vaccines. This figure summarises the reasons for vaccine hesitancy in 32/325 reporting to be not in favour of being vaccinated (A) and the main sources of information about vaccinations against SARS-CoV-2 among 325 responders to the survey (B).
See this image and copyright information in PMC

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